| NPI | 1649918673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP TAGEANT Clinical Supervisor 425-212-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-05-20 |